Perhaps it's not your third (or fourth or fifth) cold of the season, but an allergy. Most people don't consider allergies the cause of their coldlike symptoms in the winter, because the cause of most respiratory allergies — pollen — is usually not drifting about in cold and snowy climes.

Yet some of the most common allergies are to indoor things: Dust mites, mold and animal dander top the list. And in the winter, we tend to spend more time indoors with these potential triggers.

Allergies are overreactions of the immune system to foreign particles that should be innocuous. For reasons that scientists don't fully understand, some people react to dust mites or mold spores as if it they were a pathogen. There's an antibody response and an inflammatory cascade of events that leads to the classic symptoms — itchy eyes, runny nose and sneezing — says allergist Jackie Eghrari-Sabet, founder of Family Allergy and Asthma Care in Gaithersburg, Md. Sometimes the congestion is bad enough to cause sinus pressure and headaches.

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But how do you know which is which — if you have an allergy or a cold? While they are caused by different things, both a virus and an allergen set off your body's immune responses. That's why symptoms overlap — a runny or stuffy nose, a cough and sore throat, and fatigue. Some symptoms are more likely to occur with allergies, such as itchiness of the eyes, ears and back of the throat. Other symptoms, such as aches and fever, indicate a viral infection.

Another key difference is the course and persistence of symptoms. “With a cold, first you feel crummy, then you're sick and then gradually your symptoms go away,” says Joan Lehach, an integrative medicine physician specializing in allergy and asthma at Montefiore Medical Center in New York. With a cold, she says, this sequence may last a week or so. “Allergies last longer.”

Lehach says that, in winter, half of the patients who come to her are people whose family doctors have told them they're not suffering from colds.

Eghrari-Sabet says primary-care doctors can miss an allergy diagnosis when their offices are flooded with patients who have colds or the flu.

People with allergies are more likely than others to develop asthma, a more serious and chronic condition. Some studies have shown that indoor allergies are associated more strongly with asthma than outdoor (pollen) allergies.

What to do if you think you might have indoor allergies? Here's some suggestions from experts:

– Minimize your exposure. Dust mites live in bedding, upholstered furniture and carpeting; mold grows in damp places such as bathrooms and basements; and pets — well, if you have a dog or a cat, you should at least keep the animal out of rooms where you spend a lot of time, such as your bedroom.

– Cockroaches. “They are a major allergen,” Lehach says, and are widely prevalent in urban settings — both housing and schools. A study of 831 houses across the country found that two-thirds of the homes had detectable levels of cockroach allergens, and higher levels were found in high-rise apartments and older, urban homes. (Nearly half of the homes had high enough levels of dust mite allergens to produce allergic reactions.)

– Vacuum frequently, wash bedding in hot water, remove mold with a bleach solution. Pay special attention to your bedroom, suggests the American Academy of Allergy, Asthma and Immunology, because you spend so many hours there. In addition to keeping a clean house, you might want to invest in a HEPA air filter, which removes particles from air passing through it.

– If you think you might have indoor allergies, there are plenty of over-the-counter products to help relieve the symptoms of allergies, including antihistamines and decongestants. You might also try steroid nasal sprays, one of which — Nasacort — was recently approved for nonprescription sales. Studies generally show that steroid nasal sprays work better than antihistamines for symptom relief. Some allergy sufferers swear by simple saline sprays and herbal remedies that contain butterbur or biminne.

If your symptoms are ongoing and annoying enough to interfere with work, play or sleep, a visit to an allergy specialist might be in order. In a single visit, an allergist can find out what you're allergic to with a simple skin test.
Once you've narrowed down the cause (or causes), you can target the problem more directly.

“Allergy shots contain a small amount of the very thing you're allergic to,” Eghrari-Sabet says. “You become tolerant to it.” The treatment is delivered in a series of shots, typically monthly for up to five years. Allergists can also prescribe other types of medications. But the very first thing they'll do is counsel you to minimize your exposure.

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